脊髓型颈椎病患者TY - T1的钆增强模拟肿瘤和炎症;一系列案件的56例(S31.001)摩根富林明-神经学乔-神经学六世- 82 - 10补首页充SP - S31.001盟Eoin弗拉纳根AU -卡尔Krecke盟-理查德·马什盟Caterina Giannini AU -马克Keegan盟布莱恩Weinshenker Y1 - 2014/04/08 UR - //www.ez-admanager.com/content/82/10_Supplement/S31.001.abstract N2 -目的:突出一个underrecognized辐射特性的一些spondylotic脊髓炎,可能导致诊断混乱背景:spondylotic脊髓病可能与广泛的髓内有关T2-signal变化和钆增强后,可能会持续得到并导致关注另一种肿瘤/炎症病因。设计/方法:患者回顾性地从1/1/1996-12/31/2012。入选标准是:1)脊髓型颈椎病患者怀疑;2)钆增强磁共振成像;3)脊柱手术进行。电话随访评估临床症状,随后替代诊断和随访MRI发现。结果:50 6个病人,其中包括70%是男性,平均年龄为53.5岁(范围,24 - 80)。颈脊髓MRI(52个;胸,4)透露longitudinal-spindle-shaped-T2-signal hyperintensity(100%)和绳肿大(79%)。 A characteristic transverse band, or ‘pancake-like’ enhancement typically just caudal to the site of maximal spinal canal narrowing was noted in 41(73%). Forty (70%) patients were initially diagnosed with neoplastic or inflammatory myelopathies and median delay to surgery (laminectomy, 21; fusion, 21; or other, 14) was 11 months (range, 1-64). Six patients underwent spinal cord biopsy which did not reveal any alternative diagnosis. Fifty three (95%) patients were improved or stable after surgery, but gadolinium enhancement regressed slowly. Seventy five percent had residual enhancement 12 months post-operatively often resulting in concerns about accuracy of initial diagnosis. Thirty six (64%) were ambulatory without aids, 6 (11%) required a cane, 9 (16%) a walker and 5 (7%) a wheelchair at last follow up (median 60 months, range 10-172). The need for a gait aid pre-operatively (p=0.005), but not delay to surgery, predicted need for gait aid at final follow-up. CONCLUSIONS: Spindle-shaped longitudinal intramedullary T2 hyperintensity with transverse ‘pancake-like’ gadolinium enhancement just caudal to the site of maximal stenosis is highly suggestive of spondylotic myelopathy. Persistent gadolinium enhancement months to years following decompressive surgery is typical. Recognition of this radiological feature is important to prevent delay in definitive decompressive surgery or subsequent inappropriate interventions.Disclosure: Dr. Flanagan has nothing to disclose. Dr. Krecke has nothing to disclose. Dr. Marsh has nothing to disclose. Dr. Giannini has nothing to disclose. Dr. Keegan has received personal compensation for activities with BIONEST Partners and GlaxoSmithKline, Inc. Dr. Keegan has received personal compensation in an editorial capacity for eMedicine. Dr. Keegan has received research support from Terumo BCT. Dr. Weinshenker has received personal compensation for activities with Novartis, Biogen Idec, and Mitsubishi Pharmaceuticals as consultant on data safety monitoring boards; and with Elan Corporation, Ono Pharmaceutical, GlaxoSmithKline Inc., Alexion and Chugai Pharmaceuticals, and Asahi Kasei Medical Company as a consultant. Dr. Weinshenker has received royalty payments from Mayo Foundation.Wednesday, April 30 2014, 2:00 pm-3:45 pm ER -